Cultural factors affecting the development of an evidence-based information service in a third sector provider of complementary cancer care Matthew Breckons Introduction Many people with cancer access complementary and alternative medicine (CAM) and a need for high quality information was emphasised in reports by the House of Lords and the National Institute for Health and Clinical Excellence. Organisational culture, incorporating people’s underlying assumptions, values and actions, has been highlighted as an important factor when attempting to introduce evidence-based practices. Opinion is divided over the relevance of evidence to CAM practice, although the influence that this has on the cultural context of a CAM organisation is not understood. Aims To identify cultural factors affecting the introduction of an evidence-based information service in a third-sector CAM organisation and, in light of factors identified, to suggest feasible innovations to achieve a more evidenced-based approach. Methods Access to the charity was gained through a Knowledge Transfer Partnership. Soft Systems Methodology, a form of action research, was used to carry out four ‘learning cycles’ in which data was collected and fed back to staff at the organisation to prompt discussion on what could be improved. Learning cycles focused on improving the quality of web-based and printed information and gaining an understanding of how the information service could be improved from staff and service-user perspectives. Results Results suggested that a lack of time and emphasis on marketing values led to difficulties feeding back results and making changes that were perceived to reduce demand for the charity’s services. A lack of management support and a reluctance to implement rules made introducing any form of information policy problematic. Additionally, structural factors such as a large team of part-time staff and a lack of financial resources led to communication difficulties as well as limiting the opportunity for staff development. Conclusions This is the first study to document systematic attempts to make evidence-based changes in a third sector CAM organisation. As such, this study has generated results demonstrating how cultural and structural constraints in this type of organisation may influence attempts to make evidence-based changes. Introduction of an initiative such as the Information Accreditation Scheme (IAS) may provide benefits to an organisation of this type by guiding the development of information production systems at the same time as raising the profile of the organisation. The findings of this study strongly suggest that, despite demands from policy makers for the provision of evidence-based CAM information, there may be systematic difficulties experienced by organisations responsible for the production of this information. Further research is needed to understand how producers of CAM information can be supported in providing high quality, evidence-based materials.

Philosophiae Doctor - PhD / Research has shown that collaborative eLearning can provide educational opportunities to groups of learners; both distance learners as well as traditional campus-based learners. It provides innovative educational methods in which learning can be constructed. The way collaborative eLearning is administered, managed, used and adopted can assist in providing information for future design and improvement of collaborative software. The objective of this research is to provide an insight into adoption and use of collaborative eLearning environments and to discover new determinants of usage. To examine the usage of an eLearning environment at the University of the Western Cape, a cross-sectional survey was conducted with Computer Science students. While this study is specific to this university, the underlying principles can be generalised to other organisational types. This study is quantitative and qualitative in nature as well as deductive and inductive. Three hundred and six valid questionnaires were analysed using quantitative methods. Soft Systems Methodology was used to manage the research process and to create conceptual models to explain the research problem and identify solutions. It was a cyclical process. Findings show that although the university’s eLearning platform is utilised, students seem to prefer free and open source platforms. They use social and collaborative applications such as WhatsApp, Telegram, Dropbox, Google Drive, Google Docs as well as email messages. Four types of technology affordances: communicative-affordance, document share-affordance, course resource-affordance, and integrity-affordance were identified as being relevant in their choice of application. Furthermore, culture—masculinity/femininity, individualism/collectivism, Uncertainty Avoidance, and Power Distance—also have an effect on the adoption of collaborative eLearning applications and software the students used for learning. Chi-Square analysis found that individualism/collectivism and Power Distance were both significant and related to the adoption and usage of collaborative eLearning. Gender was found not to be a determinant of how students view the use of collaborative eLearning software applications. Finally, it was also found that understanding use and user behaviour, could provide the theoretical guidance to inform collaborative eLearning design. The analysis and findings show that culture influences the adoption of collaborative eLearning while technology affordance plays a major role in the use of collaborative eLearning.

Submitted by Viviane Lima da Cunha (viviane@biblioteca.ufpb.br) on 2015-05-26T12:53:02Z No. of bitstreams: 1 arquivototal.pdf: 2980634 bytes, checksum: 4c7ccb2e54be16c1b0bcb01cfa7a50f5 (MD5) / Made available in DSpace on 2015-05-26T12:53:02Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 2980634 bytes, checksum: 4c7ccb2e54be16c1b0bcb01cfa7a50f5 (MD5) Previous issue date: 2015-02-27 / The Patient Safety has been, in the last decades a thematic evidenced in the Brazilian and world scenario. There are cases that refer to bad prescription, errors in medication administration , stress and professional disillusion. Attached to concerns regarding the quality of medical records, Patient Safety becomes a study of high importance for Risk Reduction, both for patients as for professionals and health services. Therefore, this study concerned to better understand the reality of management of records of Alcides Carneiro University Hospital (ACUH) a federal public institution in the city of Campina Grande, Paraíba. The aspirations for improvements in service hospital records, along with initial actions of ACUH Management Risk and Patient Safety Center, were the main indicators for this study to have its start up. The focus of this work was to understand the situation seen as problematic by the institution Hospital Records Division and, through observations and systemic reviews, identify opportunities for improvement. The methodology used was the Soft Systems Methodology (SSM), recognized worldwide in the management of public health services, especially in studies carried out in National Health Service (NHS) in Britain. The application of SSM had allowed greater understanding of how the records management is conducted in ACUH, and the main obstacles for attendance to Brazilian national guidelines Risk Management and Patient Safety. In addition to organizational learning, this study led to the construction of a project named the Medical Records Management Improvement Program (MRMIP), which may be applied by the administration of ACUH. / A Segurança do Paciente tem sido, nas últimas décadas, uma temática evidenciada no cenário nacional brasileiro e mundial. São casos que se referem à má prescrição, à administração de medicamentos de forma equivocada, ao estresse e à desilusão profissional. Atrelada à preocupação referente à qualidade dos registros médicos, a Segurança do Paciente é um estudo de suma importância para a Redução de Riscos, tanto para os pacientes quanto para os profissionais e serviços de saúde. Este estudo teve a preocupação de compreender melhor a realidade da gestão de prontuários do Hospital Universitário Alcides Carneiro (HUAC), instituição pública federal da cidade de Campina Grande, na Paraíba. Os anseios por melhorias no serviço de registros hospitalares, aliados às ações iniciais da Gerência de Risco e Núcleo de Segurança do Paciente do HUAC, foram os principais indicadores para que este estudo tivesse início. O foco foi compreender a situação tida como problemática pela Divisão de Registro Hospitalar da instituição e, por meio de observações e avaliações sistêmicas, identificar oportunidades de melhoria. A metodologia utilizada foi a Soft Systems Methodology (SSM), reconhecida mundialmente no âmbito da gestão em serviços de saúde pública, principalmente em estudos realizados pelo National Health Service (NHS), o serviço de saúde pública do Reino Unido. A aplicação da SSM ampliou o entendimento sobre a gestão de prontuários no HUAC, bem como apresentou os principais obstáculos para que sejam atendidas as diretrizes nacionais brasileiras de Gestão de Riscos e Segurança do Paciente. Além do aprendizado organizacional, este estudo propiciou a construção do Programa de Melhorias da Gestão de Prontuários (PMGP), que poderá ser aplicado pela administração do HUAC.

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2017-04-18T12:25:54Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) DISSERTAÇÃO - MPA - JOSÉ ORLANDO.pdf: 1683147 bytes, checksum: dceefacc13fbb80c75b08210bf27154d (MD5) / Made available in DSpace on 2017-04-18T12:25:54Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) DISSERTAÇÃO - MPA - JOSÉ ORLANDO.pdf: 1683147 bytes, checksum: dceefacc13fbb80c75b08210bf27154d (MD5) Previous issue date: 2016-07-27 / As organizações hospitalares compreendem uma das mais complexas unidades gerenciais, exigindo do gestor hospitalar da cadeia logística de medicamentos que, neste trabalho, são os antirretrovirais, uma proficiência no seu gerenciamento. Pois uma falha na sua distribuição, a percepção, quanto à qualidade do serviço oferecido, é imediatamente comprometida. Esta pesquisa foi realizada no Hospital das Clínicas da UFPE e objetivou avaliar a percepção da qualidade em relação à prestação de serviços logísticos no programa de medicamentos antirretrovirais. Este é um estudo exploratório-descritivo de natureza qualitativa, realizado por meio de entrevista semiestruturada, junto aos farmacêuticos e técnicos em farmácia do hospital em estudo e coordenadores logísticos do programa HIV/AIDS da Secretaria Estadual de Saúde. Um pilar, para o entendimento da qualidade em relação à prestação de serviços logísticos, é a visão sistêmica do funcionamento da cadeia de distribuição através da Soft Systems Methodology (SSM), a qual permitiu compreender seu funcionamento a partir das diferentes percepções. Desta situação adveio à importância também em avaliá-la, com base nas dimensões da qualidade percebida em serviços logísticos, quais sejam: confiabilidade no prazo de entrega; confiabilidade da quantidade e do produto correto; flexibilidade no serviço prestado; disponibilidade; apoio pós-entrega; armazenamento etc.; no sentido de realizar um monitoramento mais apurado dos processos ou propor ações que previnam problemas futuros no atendimento às necessidades dos profissionais do programa e usuários convivendo com o HIV/AIDS. Os resultados obtidos possibilitaram uma avaliação detalhada do funcionamento da cadeia logística dos medicamentos antirretrovirais, a importância de uma gestão eficiente do estoque, do fluxo de informações e do planejamento real da demanda. Entende-se, então, a necessidade de repensar a estrutura física atual no sentido de possibilitar um atendimento humanizado aos usuários e familiares, e rever, junto à coordenação logística estadual, as cláusulas contratuais firmadas. Por fim, ficou evidente que algumas dimensões avaliadas demandam mudanças operacionais, tendo em vista o alto valor monetário agregado; e que o acesso contínuo a terapia traz consigo, não só a satisfação dos profissionais e usuários, a credibilidade dos serviços e a construção de uma imagem positiva, mas principalmente, o aumento da sobrevida desses usuários. / Hospital organizations have one of the most complex unit managements, demanding from drugs supply chain hospital manager, which in this paper is antiretroviral, a proficiency in management. As a distribution failure occurs, the perception about the service quality offered is immediately compromised. This research was conducted at the Hospital das Clínicas, UFPE and aimed to evaluate the perception of quality related to logistic services provision in the antiretroviral drug program. This is an exploratory-descriptive qualitative study, conducted through semi-structured interviews with the study hospital’s pharmacists and pharmacy technicians and logistical coordinators of the HIV/AIDS program from the State Department of Health. A foundation to understand the quality associated to logistic services provision is a systemic view about the supply chain operation through Soft Systems Methodology (SSM), which allows the operation understanding from different perceptions. This situation also originated the importance to evaluate it based on dimensions of perceived quality in any logistic services: reliability in prompt delivery, amount and correct product reliability, service flexibility, availability, post-delivery support, etc., in order to achieve a more accurate monitoring process or propose actions to prevent future problems to program’s professionals and users living with HIV/AIDS. The results enabled a detailed assessment of the supply chain functioning from antiretroviral drugs, the importance of an efficient stock management, the information flow and the real demand planning. It made to understand the need to rethink the current physical structure in order to allow a humanized care to patients and families, and review along with the state logistic coordination the contract terms signed. Finally, it was clear that some dimensions evaluated require operational changes, considering the high monetary value; and the continued access to therapy brings not only the professionals and users’ satisfaction, the credibility of services and building a positive image, but mainly increasing these users survival.

Almost one quarter of children, by the time they reach 18 years old, will have experienced domestic violence (DV) at some point in their childhood (Bentley et al., 2017). The impact of DV on children can affect the areas of emotional and social development, communication, physical health and learning, in the home and school environments. Rather than being passive witnesses to abuse, children experience it through all of their senses. Despite a wealth of research exploring the areas of DV and the impact on children, there is limited current research in the area of DV in relation to children in education, and teacher perspectives of DV. This research therefore aims to add to the body of literature by exploring the educational experiences of children who have lived with domestic abuse and the views of teachers supporting those children. There were two phases to the research. Phase one involved working with children to explore their views of education and what was important to them, using image-based data collection methods. Phase two explored teacher perspectives of the effects of DV on children and a discussion about the implications of phase one, using a soft systems methodology approach. A visual arts-based methodology was utilised in order to allow children to explore and share their thoughts and feelings in a creative way; to tell their stories, take ownership over their own information and feel empowered to do so through a method of their choosing. The data was analysed using interpretative phenomenological analysis. The findings illustrated that children’s experiences of school were centred on six key areas: play, education, identity, relationships, feeling safe and linking the past to the future. Teachers in the study expressed an understanding of DV and the impact on children and families. They described what children think about school and what children need at school. However, there were many barriers and conflicts for teachers in providing such support, and they felt disempowered to enact positive change for those children. Visual methodology allowed for children to express their views in a way that linked the past with the future that helped them navigate the present situation. The implications for educational psychology practice were explored at various levels of working. In particular, with relation to eliciting child voice, supporting schools at a systems level and promoting organisational change.

This thesis has two distinct research threads. One thread examines the effectiveness of technology support on the performance of focus groups. Unlike previous research, the work described in this thesis addresses the fundamental issue that groups are social systems, and that comprehensive measurement of the effectiveness of group activities requires assessment of both the task-oriented and social aspects of the group activity. In this research, four different communication modes are used to compare group effectiveness. The second research thread in this thesis is the use of Systems Thinking, and specifically Soft Systems Methodology (SSM), as the framework for inquiring into the effects of technology support on group effectiveness. The strategy in this thesis for developing and evaluating hypotheses extends the general descriptions and guidance in the literature on using SSM for hypothesis testing. Systems thinking also provides the basis for examining the prevailing ???profile deviation??? view that the better the fit between the group task and the technology support the greater the group performance. Using the six perspectives of fit developed by Venkatraman (1989), the most common GSS models and other models developed to examine Task-Technology Fit (TTF) are analysed. The results show that group performance models are most often tested from a ???profile deviation??? perspective and TTF models developed from a profile deviation perspective claim to have predictive and descriptive validity for assessing the level of group performance. To assess whether an SSM based approach can improve the predictive and/or descriptive analysis of the impact of technology support on group work, a field experiment was conducted at the Australian Defence Force Academy. Twenty focus groups of officer cadets assessed their military training program using a GSS in one of four communication modes. The results showed little predictive or descriptive support for the profile deviation perspective of TTF when measuring the group???s overall effectiveness, task effectiveness, participant satisfaction or group relations. The alternative ???gestalt??? perspective, operationalised in this research by using SSM, provided a more comprehensive approach to examining the effectiveness of technology support for group work.

With the first commitment of the Kyoto Protocol commencing in 2008, many signatory governments have identified bio fuels as a favoured response to the problem of fulfilling their countries' pledges to reduce total greenhouse gas emissions to 1990 levels. Despite the tendency for pressure over climate change to expedite the commercialisation process, detailed evaluation of the claimed benefits, likely efficacy or environmental impact of bio fuels in New Zealand in the form of the Bio fuels Sales Obligation policy (BSO): a mandate place on the Oil Companies to supply a percentage of bio fuel. Systems thinking propound the notion of complex interrelatedness: a pivotal concept in our current understanding of the cumulative effects of greenhouse gas emissions and their relationship to climate change. It also recognizes that the multiple ways in which different stakeholders perceive a contentious question are an integral feature of any problematical situation. By applying systems concepts to qualitative research, Soft Systems Methodology (SSM) is therefore particularly suitable for the analysis of multiple stakeholder discourse in this situation. The present study employs SSM to examine stakeholder opinion through the construction of conceptual models in the form of rich pictures and root definitions. The researcher invited diverse stakeholders to ‘see what they were thinking’ and reflect upon the beliefs and assumptions that informed their views with respect to New Zealand bio fuels development. With reference to official documentation arising from the policy development process and through a series of interviews and a focus group, the research examines perceptions of the consultation process on bio fuels development and its contribution to informed decision-making. The study data indicates that the scope of enquiry tended to be restricted by early presuppositions regarding the consultation process and its desired outcomes, which consequently shifted the focus of consultation the enquiry from an assessment of the desirability of bio fuels to an appraisal of the feasibility of government policy. However inadvertently, communication was distorted. The research examines the basic assumptions that shaped the discourse and enabled already established opinions to prevail. Furthermore, the thesis explores how using SSM to surface tacit assumptions and challenge proposed models of intervention can help improve the reflexivity of discourse and decision-making. By ensuring open communication remains at the centre of discourse, SSM could provide a means of establishing productive conditions for learning and co-creative dialogue. Consequently the study has important implications for how the ‘health’ of public discourse in New Zealand might be sustained when addressing other similarly complex issues.

The research investigates the role of Knowledge Management (KM) in supporting innovation and learning in the construction industry. The Construction industry is complex in nature and notoriously fragmented suffering high losses in productivity. Being a substantial part of the national economy, the construction industry greatly influences the country's GDP (Gross Domestic Product). Innovation has lately been regarded as the key to improve its productivity and to change traditional and fundamental thinking that has plagued the industry for a long time leading to new and more rational philosophies. The research demonstrates that KM may act as an enabler of such innovation by facilitating organisational learning. The research is carried out in two phases. In Phase 1, the research employs grounded theory methodology to develop and map out the current state of knowledge related activities being undertaken in two leading Australian construction organisations. This results in the development of a model, the main depiction of which is a segregation between three crucial components (people, process & technology) of an organisation required to successfully carry out the construction work. It also helps identify the gap between the organisation's internal and external knowledge sources that restricts the pull of knowledge from external knowledge sources. The culture of the organisation is considered to provide this resistance. An improvement in this state through KM is the main objective of the research which is realised in Phase 2. Soft System Methodology (SSM) is utilised as a KM tool to achieve this objective in this phase. As one of the systems approaches, it has the capacity to make sense of intricate systems like const ruction where a complex interaction between people, process and technology occurs all the time. A mission critical business process of pre-tendering of a leading Australian construction contractor organisation is selected to carry out the SSM investigation that resulted in four SSM case studies. This investigation helps explain how KM initiatives through SSM improve the integration of people, process and technology; increasing the capacity of the organisation to pull external knowledge and improve its own internal knowledge bank. All these improvements help an organisation to transform itself into a learning organisation that could continually innovate.

This research investigates the application of an adaptive ecosystem approach to the problem of the Cooum River and environs in Chennai (formerly Madras), India. The Cooum River is an extremely polluted urban stream that flows into the Bay of Bengal through the heart of Chennai, India's fourth largest metropolis. During the dry (non-monsoon) season, the upper reaches of the river are dry and flow in the river may be attributed primarily to the production of sewage by the city's population. The river is essentially a foul-smelling open sewer. Complexity of the problem is due as much to human factors (population growth, poverty, uncontrolled urban development, jurisdictional conflicts, modes of behaviour of the citizenry, and institutional culture) as to physical characteristics of the system (flat topography, tidal action, blockage of the river mouth by sand bar formation, and monsoon flooding). Uncertainty in the situation is both structural (regarding main processes and activities in the system and the nature of relationships among the various actors and elements), and parametric (having to do with scarcity, poor quality and restricted access to data). This work has drawn upon methods and techniques of Adaptive Environmental Management and Soft Systems Methodology to operate the ecosystem approach and address the problem. Specifically, this has involved a series of workshops which have brought together planners, researchers, NGOs, and other stakeholders in a participatory process oriented toward problem definition, system identification and conceptualization, determination of objectives for management, and the generation and exploration of management interventions. In addition, a central component of the program has been the development of a loosely-coupled GIS, environmental simulation model, and a decision support module. This is based upon a framework provided by participants in the first workshop in the series, and operationalizes a common understanding of the system. In addition to generating new insight into the nature of the problem situation, the research has provided a potentially useful tool to planners, managers and researchers in Chennai in the form of a GIS database and decision support system (DSS). Aside from the tool itself, it was found that the process of developing a conceptual model, and attempting to represent this in the DSS has made a significant contribution to understanding of the Cooum system. In particular, this process forced assumptions to be stated explicitly and publically, highlighted areas of uncertainty and led to new understanding in participants' conception of the problem situation. The program of research also provided a much needed forum for open debate and exchange of information which was removed from the restrictive institutional culture of government departments.

In today’s manufacturing industry there is an increased focus to produce the right product at right time and in the automotive sector the pressure on suppliers in order to deliver is high. In this matter the organization has to have clear and reachable goals together with a production system that can meet these goals.  The aim of this study was to observe and discover improvements in an assembly line called EUCD 1 at a company working in the automotive industry. The task was from a third party perspective to identify bottlenecks and put forth recommendations for the future as to how the improvement work should be carried out at the line. The production flow has been mapped out by the use observations, interviews with personnel working on the line, qualitative and quantitative data along with System Soft methodology. The interview questions were based on Porras’ and Robertson’s Organizational framework which is divided into four sections namely technology, social factors, physical settings and organizational arrangement. The line assembles three types of gearboxes consisting of different models which make this line very complex. This case study also includes literature studies in order to support the results found in this thesis. This report includes a rich picture of the current state at the line for understanding how the line operates. Along with this observation and interviews have been made. Observations are supported by quantitative data and analyses to justify the problematic situation in the production line. The current state has been analysed with the help of the theories used and it revealed a distinct gap between the actual production and desired goals for the organization. The company used a methodology of solving the everyday problematic issues by temporary solutions which led to the reappearance of problems again.   The analyses conducted have resulted in general recommendation as to how the organization should be working to eliminate the different bottlenecks permanently. A desired state has been put forward that includes how the company should operate in a long term future to make the EUCD 1 assembly line more stable with less variation in standstill situations. The report ends with a discussion of the methodology used along with the findings obtained. The three research questions are answered along with discussions regarding how we could have done this thesis in a different manner. The reports sums up with a section for reliability of the data collected and what future studies can be conducted in the area.